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Thread: This time it's the Independent telling us we'll all die of Afib...

  1. #1

    Default This time it's the Independent telling us we'll all die of Afib...

    https://www.independent.co.uk/news/h...-a8810166.html

    The study this is based on is here: https://www.researchgate.net/publica...e_Cohort_Study

    Abstract:
    Background The influences of low carbohydrate diets in cardiovascular disease are controversial. Few studies have examined the relationship of carbohydrate intake and risk of incident atrial fibrillation (AF). We aimed to evaluate the association between carbohydrate intake and the risk of incident AF in the Atherosclerosis Risk in Communities (ARIC) study. Methods and Results We included 13,385 participants (age, 54.2±5.8 years, 45.1% male and 74.7% white) who completed a dietary questionnaire at baseline (1987-1989) in the ARIC study. The primary outcome was incident AF, which was identified by electrocardiogram performed during study exams, hospital discharge codes and death certificates. We used multivariable Cox’s hazard regression models to assess the association between carbohydrate intake and incident AF. Restricted cubic spline with 4 knots was used to express the dose-response association. We further explored the effects of specific food source (animal-based vs plant-based) used to replace carbohydrate intake in low carbohydrate intaking setting. During a median follow-up of 22.4 years, 1,808 cases (13.5%) of AF occurred. The hazard ratios for incident AF associated with a 1-SD (9.4%) increase in carbohydrate intake as a percentage of energy intake was 0.82 (95% CI, 0.72, 0.94), after adjustment for traditional AF risk factors and other diets factors. Results were similar when individuals were categorized by carbohydrate intake quartiles: the HR for incident AF comparing the 2nd, 3rd and 4th quartiles of carbohydrate intake as a percentage of energy to the 1st quartile were 0.79 (95% CI 0.68-0.92), 0.77 (95% CI 0.64-0.93) and 0.64 (95% CI 0.49-0.84) separately. Restricted cubic splines also showed a similar tendency of risk of incident AF in patients with carbohydrate intake in the range of less than 62% of daily total energy. No association was found between the type of protein or fat used to replace the carbohydrate and risk of incident AF. Conclusions Low carbohydrate diets were associated with increased risk of incident AF, regardless of the type of protein or fat used to replace the carbohydrate.


    They used data from the ARIC study, where participants were given dietary questionnaires in 1987 - 89 and then followed up every 3 years, ending in 1996-98.

    While I can't get access to the full studies, I can see the issues immediately:
    1. Dietary questionnaires
    2. long gaps in followup
    3. Old data.
    4. ARIC was not designed to study Afib or the effects of diet on cardiovascular outcomes. From their own website "ARIC is designed to investigate the causes of atherosclerosis and its clinical outomes, and variation in cardiovascular risk factors, medical care and disease by race, gender, location, and date"

    So I'm guessing this is just another candidate for the circular filing cabinet.

  2. #2

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    12 years low carb here. No sign of Afib so far.

  3. #3

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    Thanks for unpacking that one nicely Hugh!
    Gilli - DLTBGYD but more importantly KCHO

  4. #4
    Super Member roseymary's Avatar
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    Ditto nearly 5 years of mostly low carb and no atrial fibrillation here either, and my genetic stock indicates this might be likely.

    Never trust anything based on food questionnaires, people write what they think the researchers want to see, leaving off the big Macs etc.
    One is too many a thousand not enough.

  5. #5

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    Ten Lifestyle Modification Approaches to Treat Atrial Fibrillation
    I can't access the full text of the Low Carbohydrate Diets and Risk of Incident Atrial Fibrillation paper and without that it's difficult to comment.
    However this paper talking about the main risk factors for Atrial Fibrillation list Smoking 36% reduction if you quit.
    Hypertension 56% increased risk of atrial fibrillation
    alcohol-induced atrial fibrillation has 10% increased risk of atrial fibrillation but drinking red bull instead of alcohol may be a cause of atrial fibrillation.
    Atrial fibrillation is four times higher in patients with obstructive sleep apnea
    Acute sleep deprivation increases AF risk by 3.36 times
    Diabetes mellitus and obesity also contribute greatly to atrial fibrillation. This risk has been shown to be around 40% more with diabetes.

    Many of these factors associated with increased risk of AF, such as Hypertension, Diabetes, Obesity, are remedied by adopting a lower refined carbohydrate intake therefore it is difficult to explain why a lower refined carb diet based on real unprocessed foods may be likely to lead to an increase in AF.


    The Daily Mail version of this pressrelease shows
    "Researchers then divided the participants into three groups representing low, moderate and high carb intake, reflecting diets in which carbohydrates comprised less than 44.8 percent of daily calories, 44.8 to 52.4 percent of calories, and more than 52.4 percent of calories, respectively."
    I don't think 45% of calories from carb counts as a low carb diet.

    Study participants were asked to report their daily intake of 66 different food items in a questionnaire.
    The researchers used the information along with the Harvard Nutrient Database to estimate each participant's daily carb intake and the proportion of daily calories that came from carbohydrates.
    This looks like another Harvard data mining expedition to see out nonsense statistics and p values.
    How any intelligent person can connect 44.8% of calories from carbs with a ketogenic diet is beyond believe.
    Last edited by TedHutchinson; 7th March 2019 at 09:27 AM.

  6. #6

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    "The Daily Mail version of this pressrelease shows
    "Researchers then divided the participants into three groups representing low, moderate and high carb intake, reflecting diets in which carbohydrates comprised less than 44.8 percent of daily calories, 44.8 to 52.4 percent of calories, and more than 52.4 percent of calories, respectively."
    I don't think 45% of calories from carb counts as a low carb diet."

    Which just goes to show the DM don't have the faintest idea what they are talking about. Ever.
    Sue - the first "no thank you" is the easiest

  7. #7

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    Quote Originally Posted by TedHutchinson View Post
    How any intelligent person can connect 44.8% of calories from carbs with a ketogenic diet is beyond believe.
    Let me see if I can do the math here. Let's go with the 2,500 calorie/day diet (these studies are mostly done on men and that's the calorie count recommended)
    44.8% of 2,500 is 1120. Divide that by 4 (the official number of calories per gram of carbohydrate) and the answer is 280

    280g carbohydrate/day isn't even close to low carb

    The other question that never gets asked is "who was eating low(ish) carb in the 1980s?" The answer to that is difficult, possibly a few diabetics as they, especially Type 1, used to be told to restrict carbs to around 50g/day, but not the sort of health-conscious person who's eating low-carb these days.

  8. #8
    Club Member grumbleweed's Avatar
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    As a health concious, pregnant female in 1985, I was eating grains and legumes by the bucket load. I gained a frightening amount of weight, which stuck to me until I started Harcombe. Don't know about anyone else, but I was eating all the wrong things for me...but they were healthy, right?
    I saw a discussion about this study on a keto site...I think it may have been reddit...and after scoffing at it, the consensus amongst posters was that irregular heartbeats due were to lack of electrolytes when moving from highly processed to cleaner eating.. Maybe someone with more knowledge can comment.
    Dear Stomach,you are bored,not hungry. So shut up.

  9. #9
    Club Member grumbleweed's Avatar
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    Haha...i just had a look at my Google news feed. The first headline was the DMs take on this study, followed by an article in the Express extolling the best lifestyle change for T2 patients. You guessed it...low carb! No wonder ordinary people are confused and frustrated...and don't give a damn.
    Dear Stomach,you are bored,not hungry. So shut up.

  10. #10
    Super Member Mamie's Avatar
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    I was the same GW. I’d still love a big bowl of split pea or lentil soup but I know i’d suffer.

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